Chong V F, Fan Y F
Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Head Neck. 1997 Mar;19(2):121-5. doi: 10.1002/(sici)1097-0347(199703)19:2<121::aid-hed6>3.0.co;2-6.
Nasopharyngeal carcinoma (NPC) may infiltrate the pterygopalatine fossa (PPF) and the maxillary nerve. This study illustrates involvement of the maxillary nerve in the PPF with perineural spread to the cavernous sinus.
One hundred and fourteen patients with proven NPC were studied using magnetic resonance imaging (MRI) and computed tomography (CT). The images were retrospectively reviewed for PPF infiltration and maxillary nerve involvement.
Seventeen (15%) patients showed infiltration of the PPF. Four patients had maxillary nerve involvement and a perineural spread to the cavernous sinus. Of the 17 patients with PPF infiltration, 8 (47%) patients showed hypoesthesia in the distribution of the infraorbital nerve. All 4 patients with contrast-enhancement of the maxillary nerve exhibited infraorbital neuropathy.
Infiltration of the maxillary nerve in the PPF with intracranial spread is uncommon but should be suspected in patients with infraorbital neuropathy. This is important as it affects both prognosis and radiation treatment planning.
鼻咽癌（NPC）可能侵犯翼腭窝（PPF）和上颌神经。本研究阐述了上颌神经在翼腭窝受累并沿神经周围蔓延至海绵窦的情况。
对114例经证实的鼻咽癌患者进行磁共振成像（MRI）和计算机断层扫描（CT）检查。对图像进行回顾性分析，以评估翼腭窝浸润和上颌神经受累情况。
17例（15%）患者显示翼腭窝浸润。4例患者出现上颌神经受累并沿神经周围蔓延至海绵窦。在17例翼腭窝浸润患者中，8例（47%）患者眶下神经分布区出现感觉减退。所有4例上颌神经强化的患者均表现为眶下神经病变。
上颌神经在翼腭窝受累并向颅内蔓延的情况并不常见，但眶下神经病变患者应怀疑有这种情况。这一点很重要，因为它会影响预后和放射治疗计划。
